@article{ref1,
title="Late onset depression: dopaminergic deficit and clinical features of prodromal Parkinson's disease: a cross-sectional study",
journal="Journal of neurology, neurosurgery, and psychiatry",
year="2020",
author="Kazmi, Hiba and Walker, Zuzana and Booij, Jan and Khan, Faraan and Shah, Sachit and Sudre, Carole H. and Buckman, Joshua E. J. and Schrag, Anette-Eleonore",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Late onset depression (LOD) may precede the diagnosis of Parkinson's  disease (PD) or dementia with Lewy bodies (DLB). We aimed to determine the rate of  clinical and imaging features associated with prodromal PD/DLB in patients with LOD. <br><br>METHODS: In a cross-sectional design, 36 patients with first onset of a depressive  disorder (Diagnostic and Statistical Manual of Mental Disorders IV criteria)  diagnosed after the age of 55 (LOD group) and 30 healthy controls (HC) underwent a  detailed clinical assessment. In addition, 28/36 patients with LOD and 20/30 HC  underwent a head MRI and 29/36 and 25/30, respectively, had dopamine transporter  imaging by (123)I-ioflupane single-photon emission computed tomography (SPECT)  imaging. Image analysis of both scans was performed by a rater blind to the  participant group. <br><br>RESULTS of clinical assessments and imaging results were compared  between the two groups. <br><br>RESULTS: Patients with LOD (n=36) had significantly worse  scores than HC (n=30) on the PD screening questionnaire (mean (SD) 1.8 (1.9) vs 0.8  (1.2); p=0.01), Movement Disorder Society Unified Parkinson's Disease Rating Scale  total (mean (SD) 19.2 (12.7) vs 6.1 (5.7); p<0.001), REM-sleep behaviour disorder  screening questionnaire (mean (SD) 4.3 (3.2) vs 2.1 (2.1); p=0.001), Lille Apathy  Rating Scale (mean (SD) -23.3 (9.6) vs -27.0 (4.7); p=0.04) and the Scales for  Outcomes in PD-Autonomic (mean (SD) 14.9 (8.7) vs 7.7 (4.9); p<0.001). Twenty-four  per cent of patients with LOD versus 4% HC had an abnormal (123)I-ioflupane SPECT  scan (p=0.04). <br><br>CONCLUSIONS: LOD is associated with increased rates of motor and  non-motor features of PD/DLB and of abnormal (123)I-ioflupane SPECTs. These results  suggest that patients with LOD should be considered at increased risk of PD/DLB.<p /> <p>Language: en</p>",
language="en",
issn="0022-3050",
doi="10.1136/jnnp-2020-324266",
url="http://dx.doi.org/10.1136/jnnp-2020-324266"
}